In first-time mothers requiring vacuum-assisted delivery, a lateral episiotomy (angled cut) in the tissue between the vaginal and anal opening more than halves the risk of obstetric anal sphincter injury, a severe form of perineal trauma between the vulva and anus.
Karolinska InstitutetJun 18 2024 In first-time mothers requiring vacuum-assisted delivery, a lateral episiotomy in the tissue between the vaginal and anal opening more than halves the risk of obstetric anal sphincter injury, a severe form of perineal trauma between the vulva and anus. This according to a randomized clinical study led by researchers at Karolinska Institutet and Stockholm's Danderyd Hospital , the results of which are published in The BMJ.
"Women giving birth for the first time and requiring instrumental birth are at the highest risk of sustaining OASI," says Sophia Brismar Wendel, associate professor in obstetrics and gynecology at the Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet and senior consultant at the Department of Women's Health, Danderyd Hospital.
The lateral episiotomy reduced the risk of OASI by an average of 53 per cent. Among the women assigned to the procedure, 6.1 per cent sustained an OASI, compared to 13.1 per cent in the comparison group. Moreover, the procedure did not increase the risk of severe blood loss, negative birth experience, prolonged hospitalization or additional complications. However, the risk of wound complications such as wound infection and wound dehiscence was increased in the episiotomy group.
The trial is also gathering data on the women's self-reported symptoms at one and five years after childbirth. The results from the one-year follow-up will soon be analyzed, which might give some answers about any differences in symptoms, such as anal incontinence and sexual function.
Hospital Incontinence Research Trauma Vaginal Vulva Wound
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Study finds perineal cut reduces the risk of serious birth injuryIn first-time mothers requiring vacuum-assisted delivery, a lateral episiotomy (angled cut) in the tissue between the vaginal and anal opening more than halves the risk of obstetric anal sphincter injury, a severe form of perineal trauma between the vulva and anus.
Read more »